<h4 class="page-header">Autofill Forms Test Page</h4>
<form action="" method="post">
<p>
	<fieldset>
		<legend>Textfields</legend>
		<table>
			<tr>
				<td><label for="user_name">Username:</label></td>
				<td><input type="text" id="user_name" name="user_name"/></td>
			</tr>
			<tr>
				<td><label for="email">E-Mail:</label></td>
				<td><input type="text" id="email" name="email"/></td>
			</tr>
			<tr>
				<td><label for="full_name">Full Name:</label></td>
				<td><input type="text" id="full_name" name="full_name" value="Tom Bombadil"/></td>
			</tr>
			<tr>
				<td><label for="street_1">Street Line 1:</label></td>
				<td><input type="text" id="street_1" name="street_1"/></td>
			</tr>
			<tr>
				<td><label for="street_2">Street Line 2:</label></td>
				<td><input type="text" id="street_2" name="street_2"/></td>
			</tr>
			<tr>
				<td><label for="city">City:</label></td>
				<td><input type="text" id="city" name="city"/></td>
			</tr>
			<tr>
				<td><label for="state">State:</label></td>
				<td><input type="text" id="state" name="state"/></td>
			</tr>
			<tr>
				<td><label for="zip">ZIP/Postal Code:</label></td>
				<td><input type="text" id="zip" name="zip"/></td>
			</tr>
			<tr>
				<td><label for="phone">Phone Number:</label></td>
				<td><input type="text" id="phone" name="phone"/></td>
			</tr>
			<tr>
				<td><label for="homepage">Homepage:</label></td>
				<td><input type="text" id="homepage" name="homepage"/></td>
			</tr>
		</table>
	</fieldset>
</p>
<p>
	<fieldset>
		<legend>Selections, Checkboxes and Radio Buttons</legend>
		<p>
			<label for="selection_single">Hitchhiker books:</label><br />
			<select id="selection_single" name="selection_single">
				<option>The Hitchhiker's Guide to the Galaxy </option>
				<option>The Restaurant at the End of the Universe</option>
				<option>Life, the Universe and Everything</option>
				<option>So Long, and Thanks For All the Fish</option>
				<option>Mostly Harmless</option>
			</select>
		</p>
		<p>
			<label for="selection_single">Star Wars episodes:</label><br />
			<select id="selection_multiple" name="selection_multiple[]" multiple="multiple">
				<option>Star Wars Episode IV: A New Hope</option>
				<option>Star Wars Episode V: The Empire Strikes Back</option>
				<option selected="selected">Star Wars Episode VI: Return of the Jedi</option>
			</select>
		</p>
		<p>
			<input type="checkbox" id="silmaril" value="silmaril" name="checkbox[]"/><label for="silmaril">The Silmarillion</label><br />
			<input type="checkbox" id="hobbit" value="hobbit" name="checkbox[]" checked="checked"/><label for="hobbit">The Hobbit</label><br />
			<input type="checkbox" id="lotr" value="lotr" name="checkbox[]"/><label for="lotr">The Lord of The Rings</label><br />
		</p>
		<p>
			<input type="radio" id="martin" value="martin" name="radio" checked="checked"/><label for="martin">Goerge R.R. Martin</label><br />
			<input type="radio" id="tolkien" value="tolkien" name="radio"/><label for="tolkien">J.R.R. Tolkien</label><br />
			<input type="radio" id="adams" value="adams" name="radio"/><label for="adams">Douglas Adams</label><br />
			<input type="radio" id="pratchett" value="pratchett" name="radio"/><label for="pratchett">Terry Pratchett</label><br />
		</p>
	</fieldset>
</p>
<p>
	<fieldset>
		<legend>Textarea</legend>
		<p>
		<label for="textarea">Multiline text:</label><br />
		<textarea id="textarea" name="textarea" cols="50" rows="5">"In the beginning the Universe was created. This has made a lot of people very angry and has been widely regarded as a bad move."
		Douglas Adams</textarea>
		</p>
	</fieldset>
</p>
<p><input type="submit" value="Submit"/></p>
</form>